Fracture of distal humerus: MIPO technique with visualization of the radial nerve. 2014

Daniel Romano Zogbi, and Alberto Maranon Terrivel, and Guilherme Grisi Mouraria, and Maurício Leal Dias Mongon, and Fernando Kenji Kikuta, and Américo Zoppi Filho
Universidade Estadual de Campinas, Department of Orthopedics and Traumatology, Campinas, SP, Brazil, Department of Orthopedics and Traumatology, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil.

OBJECTIVE To evaluate the outcomes in patients treated for humerus distal third fractures with MIPO technique and visualization of the radial nerve by an accessory approach, in those without radial palsy before surgery. METHODS The patients were treated with MIPO technique. The visualization and isolation of the radial nerve was done by an approach between the brachialis and the brachiorradialis, with an oblique incision, in the lateral side of the arm. MEPS was used to evaluate the elbow function. RESULTS Seven patients were evaluated with a mean age of 29.8 years old. The average follow up was 29.85 months. The radial neuropraxis after surgery occurred in three patients. The sensorial recovery occurred after 3.16 months on average and also of the motor function, after 5.33 months on average, in all patients. We achieved fracture consolidation in all patients (M=4.22 months). The averages for flexion-extension and prono-supination were 112.85° and 145°, respectively. The MEPS average score was 86.42. There was no case of infection. CONCLUSIONS This approach allowed excluding a radial nerve interposition on site of the fracture and/or under the plate, showing a high level of consolidation of the fracture and a good evolution of the range of movement of the elbow. Level of Evidence IV, Case Series.

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